Preferred United Plans® “Alternative Funding” (PUP AF) is a small employee group self-funded health program. Companion Life Insurance (AM Best A+ Superior) is the aggregate stop-loss carrier.
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PUP-AF AVAILABILITY IN THE FOLLOWING STATES
• Michigan • Ohio • Kentucky
SecureOne Benefit Administrators has access to multiple networks based upon the specific state the employer is located in.
CAPITATED FUNDING
Preferred United Plans® “Alternative Funding” is broken down as one would see under fully insured; EE, ES, EC & Family.
Preferred United Plans® “Alternative Funding” is broken down as one would see under fully insured; EE, ES, EC & Family.
PREFERRED UNITED PLANS® “ALTERNATIVE FUNDING” FEE COVERS
Implementation, Plan Documents/SPD’s, SBC’s, Networks, Banking Reconciliation, COBRA, run-out claims, administration, case management, precertification, Rx claims, medical claims, on-line enrollment, health portal, MDLive and agent fees are all included in the pricing of Preferred United Plans® “Alternative Funding”.
The Employer (Plan Sponsor) must meet the contractual obligation of the Administrative Contract with SecureOne and the stop-loss carrier, Companion Life Insurance Company. SecureOne bills out electronically by the 15th of each month for all Fees, Premiums, and Claims Funding which must be paid by the 1st of the month. As long as the terms of the contract are met, and required payments are received on time, should claims processed during the month exceed what is in the Employer Claims Funding account, the Employer owes nothing more.
During the same time frame, should the claims paid exceed the amount collected, based upon the terms of the stop-loss contract, the employer may owe nothing.
Implementation, Plan Documents/SPD’s, SBC’s, Networks, Banking Reconciliation, COBRA, run-out claims, administration, case management, precertification, Rx claims, medical claims, on-line enrollment, health portal, MDLive and agent fees are all included in the pricing of Preferred United Plans® “Alternative Funding”.
The Employer (Plan Sponsor) must meet the contractual obligation of the Administrative Contract with SecureOne and the stop-loss carrier, Companion Life Insurance Company. SecureOne bills out electronically by the 15th of each month for all Fees, Premiums, and Claims Funding which must be paid by the 1st of the month. As long as the terms of the contract are met, and required payments are received on time, should claims processed during the month exceed what is in the Employer Claims Funding account, the Employer owes nothing more.
During the same time frame, should the claims paid exceed the amount collected, based upon the terms of the stop-loss contract, the employer may owe nothing.
| Employers have access to: | |
| • Monthly Premium Billing Statements | • Enrollment |
| • Summary of Benefits & Coverage (SBC) | • Plan Document |
| • Financial Reporting Timetable | • EOBs |
| • Network Links |
| Members have access to: | |
| • Personal Explanation of Benefits | • Deductibles & Out of Pocket Accumulators |
| • Health e-360/Newsletters | • Network Links |
| • Summary of Benefits & Coverage (SBC) | • Spanish Language Conversion |
| • Transparency Requirement | • Prescription Drugs Overview |
| • ID Card | • Live Chat & Emails to Customer Service |
MDLIVE - Telehealth that is provided through Preferred United Plans® "Alternative Funding"
